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Klin Monbl Augenheilkd 2017; 234(11): 1362-1371
DOI: 10.1055/s-0043-102946
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Stellenwert der selektiven Lasertrabekuloplastik (SLT)

Status of Selective Laser Trabeculoplasty (SLT)
Torsten Schlote
Augenheilkunde, Tagesklinik Ambimed, Basel, Schweiz
› Author Affiliations
Further Information

Publication History

eingereicht 17 December 2016

akzeptiert 18 January 2017

Publication Date:
28 June 2017 (online)

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Zusammenfassung

Hintergrund Die selektive Lasertrabekuloplastik (SLT) hat sich in den letzten Jahren zu einer sehr erfolgreichen Behandlungsform des Glaukoms entwickelt.

Material und Methoden Aktuelle Literaturrecherche in PubMed. Eigene klinische Erfahrungen flossen in die Bewertung von Zusammenhängen ein.

Ergebnisse Die SLT kann mit vergleichbarer Effektivität wie eine Argonlasertrabekuloplastik (ALT) oder eine medikamentöse Ersttherapie bei allen häufigen Formen des Offenwinkelglaukoms und der okulären Hypertension eingesetzt werden. Im Vergleich zur ALT zeigt die SLT Vorteile: Es wird wesentlich weniger Energie benötigt und die SLT kann wiederholt werden. Die SLT hat auch Anwendung in einigen selteneren Indikationsbereichen gefunden. Sie beeinflusst andere Formen der Glaukombehandlung nicht negativ. Die Risiken sind gering und beinhalten Druckspitzen und sehr selten Hornhautveränderungen (Endothelzellversagen, Hornhauttrübung und -vernarbung) oder ein zystoides Makulaödem. Aufgrund ihres Potenzials als Ersttherapie wird die SLT auch aktuell intensiv beforscht.

Schlussfolgerung Die SLT ist eine risikoarme Behandlungsmethode des Glaukoms mit sehr breitem Indikationsbereich. Aufgrund der Vorteile der SLT ist eine weitere Verbreitung als Ersttherapie denkbar. Die SLT ist deshalb Gegenstand der aktuellen Forschung.

Abstract

Purpose Worldwide, in recent years, selective laser trabeculoplasty (SLT) has developed into a very successful therapy for glaucoma.

Material and Methods The article provides a review of the literature from PubMed and clinical experience.

Results SLT is equally efficacious to argon laser trabeculoplasty (ALT) and to a first-line glaucoma medication. SLT can be used in most common forms of open-angle glaucoma and ocular hypertension. In contrast to ALT, SLT is repeatable and requires much less energy. SLT has been reported to be also successful in some rare forms of ocular hypertension/glaucoma. There is no negative influence of SLT to other forms of glaucoma treatment. Complications are rare and include intraocular pressure spikes, corneal scarring or corneal decompensation due to endothelial cell damage and cystoid macular edema. The potential of SLT as a first-line treatment of glaucoma is now under investigation.

Conclusion SLT is a low-risk procedure to treat glaucoma in a broad range of indications. Advantages of SLT include the potential to use SLT more and more as a primary treatment procedure. Therefore, SLT is now under intensive investigation worldwide.

Schlüsselwörter

SLT - selektive Lasertrabekuloplastik - Glaukom - okuläre Hypertension - Therapie

Key words

SLT - selective laser trabeculoplasty - glaucoma - ocular hypertension - therapy
 

  • Literatur

  • 1 Worthen DM, Wickham MG. Argon laser trabeculotomy. Trans Am Acad Ophthalmol Otolaryngol 1974; 78: OP371-OP375
    PubMedGoogle Scholar
  • 2 Krasnov MM. Laseropuncture of anterior chamber angle in glaucoma. Am J Ophthalmol 1973; 75: 674-678
    CrossrefPubMedGoogle Scholar
  • 3 Wise JB, Witter SL. Argon laser therapy for open-angle glaucoma: a pilot study. Arch Ophthalmol 1979; 97: 319-322
    CrossrefPubMedGoogle Scholar
  • 4 Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp Eye Res 1995; 60: 359-371
    CrossrefPubMedGoogle Scholar
  • 5 Kramer TR, Noecker RJ. Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes. Ophthalmology 2001; 108: 773-779
    CrossrefPubMedGoogle Scholar
  • 6 Alvarado JA, Alvarado RG, Yeh RF. et al. A new insight into the cellular regulation of aqueous outflow: how trabecular meshwork endothelial cells drive a mechanism that regulates the permeability of Schlemmʼs canal endothelial cells. Br J Ophthalmol 2005; 89: 1500-1505
    CrossrefPubMedGoogle Scholar
  • 7 Izzotti A, Longobardi M, Cartiglia C. et al. Trabecular meshwork gene expression after selective laser trabeculoplasty. PLoS One 2011; 6: e20110
    CrossrefPubMedGoogle Scholar
  • 8 Lee JY, Kagan DB, Roumeliotus G. et al. Secretion of matrix metalloproteinase-3 by co-cultured pigmented and non-pigmented human trabecular meshwork cells following selective laser trabeculoplasty. Clin Exp Ophthalmol 2016; 44: 33-42
    CrossrefPubMedGoogle Scholar
  • 9 Alvarado JA, Katz LJ, Tricedi S. et al. Monocyte modulation by aqueos outflow and recruitment to the trabecular meshwork following selective laser trabeculoplasty. Arch Ophthalmol 2010; 128: 731-737
    CrossrefPubMedGoogle Scholar
  • 10 Damji KF, Shah KC, Rock WJ. et al. Selective laser trabculoplasty v argon laser trabeculoplasty: a prospective randomized clinical trial. Br J Ophthalmol 1999; 83: 718-722
    CrossrefPubMedGoogle Scholar
  • 11 Juzych MS, Chopra V, Banitt MR. et al. Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 2004; 111: 1853-1859
    CrossrefPubMedGoogle Scholar
  • 12 Wong MO, Lee JM, Choy BN. et al. Systematic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Surv Ophthalmol 2015; 60: 36-50
    CrossrefPubMedGoogle Scholar
  • 13 Jinapriva D, DʼSouza M, Hollands H. et al. Anti-inflammatory therapy after selective laser trabeculoplasty: a randomized, double-masked, placebo-controlled clinical trial. Ophthalmology 2014; 121: 2356-2361
    CrossrefPubMedGoogle Scholar
  • 14 Nagar M, Ogunyomade A, OʼBrart DP. et al. A randomized, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005; 89: 1413-1417
    CrossrefPubMedGoogle Scholar
  • 15 Rodes KM, Weinstein R, Saltzmann RM. et al. Intraocular pressure reduction in the untreated fellow eye after selective laser trabeculoplasty. Curr Med Res Opin 2009; 25: 787-796
    CrossrefPubMedGoogle Scholar
  • 16 Onakoya AO, Olowoyeye AO, Onyekwelu OM. et al. Intraocular pressure changes post selective laser trabeculoplasty in the contralateral untreated eyes of Nigerian patients with primary open angle glaucoma. Nig Q J Hosp Med 2015; 25: 133-138
    PubMedGoogle Scholar
  • 17 Lee JW, Wong MO, Wong RL. et al. Correlation of intraocular pressure between both eyes after bilateral selective laser trabeculoplasty in open-angle glaucoma. J Glaucoma 2016; 25: e248-e252
    CrossrefPubMedGoogle Scholar
  • 18 Schlote T, Kynigopoulos M. Selective laser trabeculoplasty (SLT): 1-year results in early and advanced open angle glaucoma. Int Ophthalmol 2016; 36: 55-61
    CrossrefPubMedGoogle Scholar
  • 19 Melamed S, Ben Simon GJ, Levkovitch-Verbin H. Selective laser trabeculoplasty as primary treatment for open-angle glaucoma. A prospective, nonrandomized pilot study. Arch Ophthalmol 2003; 121: 957-960
    CrossrefPubMedGoogle Scholar
  • 20 Katz LJ, Steinmann WC, Kabir A. et al. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial. J Glaucoma 2012; 21: 460-468
    CrossrefPubMedGoogle Scholar
  • 21 European Glaucoma Society. Terminology and Guidelines for Glaucoma. 4th ed.. 2014. Im Internet: http://www.eugs.org/eng/EGS_guidelines4.asp Stand: 1.12.2016
    Google Scholar
  • 22 Lee JW, Chan CW, Wong WO. et al. A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results. Clin Ophthalmol 2014; 25: 1987-1992
    PubMedGoogle Scholar
  • 23 McIlraith I, Strasfeld M, Colev G. et al. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma 2006; 15: 124-130
    CrossrefPubMedGoogle Scholar
  • 24 Ayala M, Chen E. The influence of topical prostaglandin analogues in inflammation after selective laser trabeculoplasty treatment. J Ocul Pharmacol Ther 2012; 28: 118-122
    CrossrefPubMedGoogle Scholar
  • 25 Marlow E, Hutnik CM, Mao A. SLT and adjunctive medical therapy: a prediction rule analysis. J Glaucoma 2011; 20: 266-270
    CrossrefPubMedGoogle Scholar
  • 26 Lee JW, Liu CC, Chan JC. et al. Predictors of success in selective laser trabeculoplasty for Chinese open-angle glaucoma. J Glaucoma 2014; 23: 321-325
    CrossrefPubMedGoogle Scholar
  • 27 Francis BA, Loewen N, Hong B. et al. Repeatability of selective laser trabeculoplasty for open-angle glaucoma. BMC Ophthalmol 2016; 16: 128
    CrossrefPubMedGoogle Scholar
  • 28 Avery N, Ang GS, Nicholas S. et al. Repeatability of primary selective laser trabeculoplasty in patients with primary open-angle glaucoma. Int Ophthalmol 2013; 33: 501-506
    CrossrefPubMedGoogle Scholar
  • 29 Goldenfeld M, Geyer O, Segev E. et al. Selective laser trabeculoplasty in uncontrolled pseudoexfoliation glaucoma. Ophthalmic Surg Lasers Imaging 2011; 42: 390-393
    CrossrefPubMedGoogle Scholar
  • 30 Kent SS, Hutnik CM, Birt CM. et al. A randomized clinical trial of selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with pseudoexfoliation. J Glaucoma 2015; 24: 344-347
    CrossrefPubMedGoogle Scholar
  • 31 Lindegger DJ, Funk J, Jaggi GP. Long-term effect of selective laser trabeculoplasty on intraocular pressure in pseudoexfoliation glaucoma. Klin Monatsbl Augenheilkd 2015; 232: 405-408
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Bettis DI, Whitehead JJ, Farhi P. et al. Intraocular pressure spike and corneal decompensation following selective laser trabeculoplasty in patients with exfoliation glaucoma. J Glaucoma 2016; 25: e433-e437
    CrossrefPubMedGoogle Scholar
  • 33 Harasymowycz PJ, Papamatheakis DG, Latina M. et al. Selective laser trabeculoplasty (SLT) complicated by intraocular pressure elevation in eyes with heavily pigmented trabecular meshworks. Am J Ophthalmol 2005; 139: 1110-1113
    CrossrefPubMedGoogle Scholar
  • 34 Ayala M. Long-term outcomes of selective laser trabeculoplasty (SLT) treatment in pigmentary glaucoma patients. J Glaucoma 2014; 23: 616-619
    CrossrefPubMedGoogle Scholar
  • 35 Tojo N, Oka M, Miyakoshi A. et al. Comparison of fluctuations of intraocular pressure before and after selective laser trabeculoplasty in normal-tension glaucoma patients. J Glaucoma 2014; 23: e138-e143
    CrossrefPubMedGoogle Scholar
  • 36 Lee JW, Ho WL, Chan JC. et al. Efficacy of selective laser trabeculoplasty for normal tension glaucoma: 1 year results. BMC Ophthalmol 2015; 15: 1
    CrossrefPubMedGoogle Scholar
  • 37 Tokuda N, Inoue J, Yamazaki I. et al. [Effects of selective laser trabeculoplasty treatment in steroid-induced glaucoma]. Nihon Ganka Gakkai Zasshi 2012; 116: 751-757
    PubMedGoogle Scholar
  • 38 Nakakura S, Imamurya H, Nakamura T. Selective laser trabeculoplasty for glaucoma after penetrating keratoplasty. Optom Vis Sci 2009; 86: e404-e406
    CrossrefPubMedGoogle Scholar
  • 39 Song J, Song A, Palmares T. et al. Selective laser trabeculoplasty success in pediatric patients with glaucoma: two case reports. J Med Case Rep 2013; 7: 198
    CrossrefPubMedGoogle Scholar
  • 40 Zhang M, Li B, Wang J. et al. Clinical results of selective laser trabeculoplasty in silicone oil-induced secondary glaucoma. Graefes Arch Clin Exp Ophthalmol 2014; 252: 983-987
    CrossrefPubMedGoogle Scholar
  • 41 Narayanaswamy A, Leung CK, Istiantoro DV. et al. Efficacy of selective laser trabeculoplasty in primary angle-closure glaucoma: a randomized clinical trial. JAMA Ophthalmol 2015; 133: 206-212
    CrossrefPubMedGoogle Scholar
  • 42 Francis BA, Chopra V, Traudt B. et al. Selective laser trabeculoplasty after failed trabeculectomy in open angle glaucoma. J Clin Exp Ophthalmol 2011; 2: 176
    PubMedGoogle Scholar
  • 43 Vold SD, Dustin L. Trabectome Study Group. Impact of laser trabeculoplasty on Trabectome outcomes. Ophthalmic Surg Lasers Imaging 2010; 41: 443-451
    CrossrefPubMedGoogle Scholar
  • 44 Klamman MK, Gonnemann J, Maier AK. et al. Influence of selective laser trabeculoplasty (SLT) on combined clear cornea phakoemulsification and trabectome outcomes. Graefes Arch Clin Exp Ophthalmol 2014; 252: 627-631
    CrossrefPubMedGoogle Scholar
  • 45 Baykara M, Hamidi NA, Akova-Budak B. et al. Early results of selective laser trabeculoplasty in patients resistant to deep sclerectomy. Eur J Ophthalmol 2014; 24: 371-374
    CrossrefPubMedGoogle Scholar
  • 46 Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A. et al. Selective versus argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye (Lond) 2004; 18: 498-502
    CrossrefPubMedGoogle Scholar
  • 47 Ong K, Ong L, Ong LB. Corneal endothelial abnormalities after selective laser trabeculoplasty (SLT). J Glaucoma 2015; 24: 286-290
    CrossrefPubMedGoogle Scholar
  • 48 Lee JW, Chan JC, Chang RT. et al. Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma. Eye (Lond) 2014; 28: 47-52
    CrossrefPubMedGoogle Scholar
  • 49 Regina M, Bunya VY, Orlin SE. et al. Corneal edema and haze after selective laser trabeculoplasty. J Glaucoma 2011; 20: 327-329
    CrossrefPubMedGoogle Scholar
  • 50 Holz H, Pirouzian A. Bilateral diffuse lamellar keratitis following consecutive selective laser trabeculoplasty in LASIK patient. J Cataract Refract Surg 2010; 36: 847-849
    CrossrefPubMedGoogle Scholar
  • 51 Shihadeh WA, Ritch R, Liebmann JM. Hyphema occurring during selective laser trabeculoplasty. Ophthalmic Surg Lasers Imaging 2006; 37: 432-433
    CrossrefPubMedGoogle Scholar
  • 52 Kim DY, Singh A. Severe iritis and choroidal effusion following selective laser trabeculoplasty. Ophthalmic Surg Lasers 2008; 39: 409-411
    PubMedGoogle Scholar
  • 53 Hernández Pardines F, Molina Martín JC, Fernández Montalvo L. et al. Bilateral choroidal effusion after selective laser trabeculoplasty. Arch Soc Esp Oftalmol 2016; DOI: 10.1016/j.oftal.2016.10.001.
    PubMedGoogle Scholar
  • 54 Wu ZQ, Huang J, Sadda S. Selective laser trabeculoplasty complicated by cystoid macular edema: report of two cases. Eye Sci 2012; 27: 193-197
    PubMedGoogle Scholar
  • 55 Ha JH, Bowling B, Chen SD. Cystoid macular oedema following selective laser trabeculoplasty in a diabetic patient. Clin Exp Ophthalmol 2014; 42: 200-201
    CrossrefPubMedGoogle Scholar
  • 56 Phillis CA, Bourke RD. Bilateral subretinal fluid mimicking subretinal neovascularisation within 24 hours after selective laser trabeculoplasty. J Glaucoma 2016; 25: e110-e114
    CrossrefPubMedGoogle Scholar
  • 57 Seider MI, Keenan JD, Han Y. Cost of selective laser trabeculoplasty vs. topical medication for glaucoma. Arch Ophthalmol 2012; 130: 529-530
    CrossrefPubMedGoogle Scholar
  • 58 Schultz NM, Wong WB, Coleman AL. et al. Predictors, resource utilisation, and short-term costs of laser trabeculoplasty versus medication management in open-angle glaucoma. Am J Ophthalmol 2016; 168: 78-85
    CrossrefPubMedGoogle Scholar
  • 59 Stein JD, Kim DD, Peck WW. et al. Cost-effectiveness of medications compared with laser trabeculoplasty in patients with newly diagnosed open-angle glaucoma. Arch Ophthalmol 2012; 130: 497-505
    CrossrefPubMedGoogle Scholar
  • 60 Barkana Y, Dorairaj S. Re: Tham et al.: Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis (Ophthalmology 2014; 121: 2081–2090). Ophthalmology 2015; 122: e40-e41
    Google Scholar
  • 61 Lamoureux EL, Mcintosh R, Constantinou M. et al. Comparing the effectiveness of selective laser trabeculoplasty with topical medication as initial treatment (the Glaucoma Initial Treatment Study): study protocol for a randomised controlled trial. Trials 2015; 16: 406
    CrossrefPubMedGoogle Scholar
  • 62 Vickerstaff V, Ambler G, Bunce C. et al. Statistical analysis plan for the laser-1st versus drops-1st glaucoma and ocular hypertension trial (LiGHT): a multi-centre randomized controlled trial. Trials 2015; 16: 517
    CrossrefPubMedGoogle Scholar